| Name: | Medical Spa Moksha, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 24 Jul 2009 (15 years ago) (Companies founded in July 2009) |
| Date of dissolution: | 07 Oct 2010 |
| Entity Number: | 000-436-296 |
| Register Number: | 000436296 |
| ZIP code: | 35242 (Companies in Shelby, 35242) |
| County: | Shelby |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 500 CAHABA PARK CIRCLEBIRMINGHAM, AL 35242 |
| Principal Address: | BIRMINGHAM, AL |
Activities
MEDICAL SPA
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912231895 | 2009-09-25 | 2009-09-25 | 500 CAHABA PARK CIR, BIRMINGHAM, AL, 352425087, US | 500 CAHABA PARK CIR, BIRMINGHAM, AL, 352425087, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 205-980-9393 |
| Fax | 2059804494 |
Authorized person
| Name | DR. WILLIAM B NICKELL |
| Role | MEDICAL DIRECTOR |
| Phone | 2059809393 |
Taxonomy
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| License Number | 3370 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | 3370 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1306901517 |
| Name | Role |
|---|---|
| PLASTIC SURGERY CENTER PC | Member |
| SPA MOKSHA INC | Member |
| Name | Role |
|---|---|
| PLASTIC SURGERY CENTER PC | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
